Karri Davis
Monticello,IL
Summary
With a proven track record at Carle Health, I excel in enhancing revenue cycle efficiency and fostering provider relations. My expertise in claims assessment and conflict resolution, coupled with a knack for leadership and effective communication, drives operational excellence and compliance. Achieved significant improvements in process optimization and customer satisfaction. Accomplished Revenue Cycle Specialist at Carle Health with a strong focus on enhancing operational efficiency and building robust provider relationships. Demonstrates expertise in claims assessment, conflict resolution, and leadership, driving significant improvements in process optimization and customer satisfaction. Proven ability to implement strategies that enhance compliance and streamline operations.
Overview
39
39
years of professional experience
Work History
Provider Relations Specialist
Health Alliance Medical Plans
Champaign, IL
01.2024 - Current
- Performed audits of medical claims submitted by providers to ensure accuracy and compliance with established regulations.
- Provided training sessions to providers regarding billing procedures, coding standards, and other administrative topics.
- Researched and resolved issues related to provider contracts, credentialing requirements, and reimbursement claims.
- Facilitated dispute resolution processes between payers and providers, utilizing effective problem-solving techniques.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Responded promptly to inquiries from both internal staff members and external customers regarding provider relations matters.
- Served as a liaison between internal departments and external stakeholders.
- Maintained professional relationships with healthcare providers.
- Worked effectively in team environments to make the workplace more productive.
- Worked with cross-functional teams to achieve goals.
- Collaborated closely with team members to achieve project objectives and meet deadlines.
Revenue Cycle Supervisor
Carle Health
Urbana, IL
05.2014 - 01.2024
- Resolved customer complaints or answered customers' questions.
- Developed work schedules according to budgets and workloads, covering priority tasks.
- Created reports on key performance indicators related to the revenue cycle.
- Analyzed data from various sources to support decision making within the revenue cycle process.
- Ensured compliance with all relevant federal, state, and local laws governing healthcare reimbursement policies.
- Analyzed and reported on billing cycle data to inform management.
- Resolved customer complaints regarding billing issues in a timely manner.
- Issued work schedules, duty assignments and deadlines for office or administrative staff.
- Oversaw reconciliation efforts between third party payor remittance advice statements and accounts receivable ledgers.
- Guided employees in handling difficult or complex problems.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Oversaw complete lifecycle of revenue operations.
- Participated in subordinates' tasks to facilitate productivity or help overcome difficulties.
- Team leadership
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Recruited, interviewed and selected employees to fill vacant roles.
- Provided guidance to staff on coding, billing procedures, policies, and other technical issues.
- Managed daily operations of the billing department, ensuring timely submission of claims and accurate data entry.
- Discussed job performance problems with employees, identifying causes and issues to find solutions.
- Trained new staff members on billing systems and software applications.
- Implemented departmental policies and standards in conjunction with management to streamline internal processes.
- Participated in periodic meetings with internal departments such as IT, finance, accounting, to discuss current projects related to the revenue cycle.
- Utilized various software and tools to streamline processes and optimize performance.
- Utilized advanced technical skills and expertise to troubleshoot complex problems and implement solutions.
- Conducted testing of software and systems to ensure quality and reliability.
Accounts Receivable Representative
Carle Health
Urbana, IL
07.2010 - 05.2014
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Performed various accounts receivable functions, handled cash receipts posting, updated cash flow reports and researched chargebacks and write-offs.
- Assisted customers with billing inquiries via phone or email correspondence.
- Developed processes that improved efficiency and accuracy in the Accounts Receivable department.
- Evaluated open accounts to look for past-due balances and pursue collection strategies.
- Analyzed financial data related to accounts receivable transactions.
- Utilized various software and tools to streamline processes and optimize performance.
Patient Service Representative
Carle Health
Urbana, IL
03.1986 - 07.2010
- Verified demographics and insurance information to register patients in computer system.
- Utilized technology and specialized software to maximize productivity.
- Inputted patient demographic data into electronic health record system.
- Collaborated with clinical and administrative staff to meet patient needs.
- Conducted financial counseling for patients, explaining payment options and assistance programs.
- Received patient inquiries or complaints and directed to appropriate medical staff members.
- Greeted patients upon arrival and directed them to the appropriate area.
- Scheduled patient appointments over phone and in person, maximizing productivity.
- Assisted in the implementation of new technologies and processes to improve patient access services.
- Adhered to HIPAA regulations when handling confidential patient information.
- Answered patient questions and fielded complaints to resolve issues.
- Coordinated with clinical staff to manage patient flow, reducing wait times and improving satisfaction.
Education
Associate of Applied Science - General Studies
Parkland College
Champaign, IL12-2012
Skills
- Claims Assessment
- Healthcare Provider Training
- Regulatory compliance
- Conflict Resolution
- Contract Compliance Management
- Data Interpretation
- Billing procedures
- Financial reporting
- Workforce Development
- Project Coordination
- Prioritization and Scheduling
- Effective Team Coordination
- Accounts Receivable Oversight
- Customer service
- Patient registration
- Effective communication
References
References available upon request.
Timeline
Provider Relations Specialist
Health Alliance Medical Plans
01.2024 - Current
Revenue Cycle Supervisor
Carle Health
05.2014 - 01.2024
Accounts Receivable Representative
Carle Health
07.2010 - 05.2014
Patient Service Representative
Carle Health
03.1986 - 07.2010
Associate of Applied Science - General Studies
Parkland College
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